Be­gin­ning of the end of Oba­macare

Open en­roll­ment will re­veal the higher costs and fad­ing ser­vices

The Washington Times Weekly - - Commentary - By John Bar­rasso

Oba­macare’s third year of open en­roll­ment be­gan on Sun­day. Peo­ple hop­ing to sign up saw a web­site with fresh pho­tos and high­tech fea­tures. They found the ac­tual in­sur­ance of the pres­i­dent’s sig­na­ture law has got­ten even worse.

Un­less some­thing dra­matic hap­pens, this may be the year of the health care law’s col­lapse. Prices keep ris­ing and ser­vice keeps fad­ing. It should not sur­prise the ad­min­is­tra­tion that peo­ple are not sign­ing up.

De­spite all the Obama ad­min­is­tra­tion has done to com­pletely up­end health care in this coun­try, there are still more than 30 mil­lion unin­sured peo­ple in Amer­ica to­day. The rea­son they’re not buy­ing Oba­macare isn’t be­cause they haven’t heard enough about it. They’re not buy­ing be­cause it’s a bad deal for them.

As peo­ple log on to the gov­ern­ment ex­changes this year, they will see the tell­tale signs of Oba­macare’s im­pend­ing fail­ure. Th­ese in­clude: costs soar­ing, can­cel­la­tions mount­ing, and choices dis­ap­pear­ing.

The first thing most peo­ple will no­tice is the higher price tag. Pre­mi­ums are jump­ing by dou­ble dig­its in many states. In Alaska, pre­mi­ums will be nearly 40 per­cent higher next year. Peo­ple buy­ing in­sur­ance on the Min­nesota ex­change will pay any­where from 14 to 49 per­cent more.

Pre­mi­ums are just one part of the high-cost story. Many plans are rais­ing de­ductibles, co-pays, and other out-of-pocket costs.

Re­mem­ber when Pres­i­dent Obama’s mantra was “If you like your health care plan, you can keep it?” Now the ad­min­is­tra­tion is singing a dif­fer­ent tune: “If you have an Oba­macare plan, you bet­ter shop around.”

That’s about the only ad­vice Wash­ing­ton has for peo­ple who want to avoid bru­tal rate in­creases. If you’re will­ing to switch in­sur­ance plans each year, your rates may go up by slightly less.

For some peo­ple, their old plan won’t be avail­able at any price. This in­cludes more than a half-mil­lion peo­ple in­sured by one of the health co-ops that have shut down in 11 states over the past few months.

It also in­cludes peo­ple whose in­surer de­cided it sim­ply couldn’t af­ford to sell Oba­macare cov­er­age any­more. That’s what hap­pened in my home state, Wy­oming, where the com­pany WINHealth is drop­ping out of the ex­change en­tirely.

In some states, plans are chang­ing dra­mat­i­cally even if the com­pany re­mains. A pa­tient may find that her long-time doc­tor will no longer be a part of her plan’s net­work. Maybe the hospi­tal near­est to her home is no longer in­cluded by her in­sur­ance. Th­ese kinds of changes can leave peo­ple with very dif­fer­ent cov­er­age than they had be­fore.

As peo­ple work their way around the web­site, they may no­tice that the re­main­ing op­tions are slim­mer than ever. An­a­lysts at the Robert Wood John­son Foundation say that more of the choices will be HMOs this time around. That can mean nar­rower net­works and no out-of-net­work cov­er­age.

In some states, the num­ber of op­tions is prac­ti­cally non-ex­is­tent. Ac­cord­ing to the Kaiser Fam­ily Foundation, peo­ple liv­ing in 14 of Ne­vada’s 16 coun­ties will have only one or two com­pa­nies to pick from. In Wy­oming, with the fail­ure of WINHealth, res­i­dents will have only one op­tion.

In­sur­ance through Oba­macare is largely com­ing down to a sim­ple choice of take it or leave it. More and more Amer­i­cans are leav­ing it.

The only peo­ple who are con­sis­tently sign­ing up are the ones who get sub­si­dies from Wash­ing­ton. For them, the web­site should come with a warn­ing la­bel read­ing: “Buyer be­ware.” Ac­cord­ing to the IRS, 90 per­cent of peo­ple who re­ceived gov­ern­ment in­sur­ance sub­si­dies last year got the wrong amount.

To avoid an all-out panic over low en­roll­ment, the ad­min­is­tra­tion is try­ing to lower ex­pec­ta­tions. It’s low­ered the bar for suc­cess to around 10 mil­lion peo­ple en­rolled for 2016. That’s half of the 21 mil­lion peo­ple the non-par­ti­san Con­gres­sional Bud­get Of­fice says should be cov­ered next year. It’s also es­sen­tially flat com­pared to the 9.9 mil­lion who were en­rolled in June.

The ad­min­is­tra­tion is play­ing the low­ered ex­pec­ta­tions game be­cause they know how hard it is to con­vince more Amer­i­cans to buy gov­ern­ment­man­dated in­sur­ance that costs so much. For so many peo­ple, Oba­macare doesn’t have much to of­fer.

Even the $695 tax penalty isn’t enough in­cen­tive to co­erce peo­ple to buy. Peo­ple fac­ing premium in­creases along with a $5,000 de­ductible see lit­tle rea­son to pay for in­sur­ance they may not want, need, or be able to af­ford.

Oba­macare is fail­ing be­cause too many peo­ple want noth­ing to do with it. As the costs con­tinue to rise, more peo­ple get can­cel­la­tion no­tices, and the ex­changes of­fer fewer choices, the col­lapse will only con­tinue. We may look back at this past Sun­day as the be­gin­ning of the end. John Bar­rasso, chair­man of the Repub­li­can Pol­icy Com­mit­tee, is a sen­a­tor from Wy­oming and a physi­cian.


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